{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T23:19:17Z","timestamp":1780528757526,"version":"3.54.1"},"reference-count":58,"publisher":"Georg Thieme Verlag KG","issue":"07","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Thromb Hemost"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Antiphospholipid syndrome (APS), a disorder characterized by the presence of antiphospholipid antibodies, is commonly associated with thrombotic events and pregnancy complications. Although cardiac involvement of APS is very common, intracardiac thrombus is rare and easily misdiagnosed. In order to reduce missed diagnosis and misdiagnosis, we investigated the clinical features of APS with intracardiac mass by summarizing 50 cases (1 newly presented case and 49 additional cases collected from PubMed from 1985 to the present). There were 10 males and 40 females, with ages ranging from 8 to 75 years (median age 35.5). Intracardiac masses were distributed in four cardiac chambers. Mass size ranged from a diameter of 0.5 to 7.1\u2009cm. Clinical manifestations were heterogeneous, including dyspnea, fever, hemiparesis, limb ischemia, and other nonspecific symptoms. In 41 cases with available pathology results, 33 cases were confirmed as thrombus, 2 cases as myxoma, 3 cases as non-bacterial endocarditis, 2 cases as fibrous tissue, and 1 case as inflammatory necrosis. Among 41 cases, 18 cases were suspected of primary cardiac tumors preoperatively, while pathological examination revealed none was tumor. APS patients with intracardiac masses are extremely rare, mostly seen in young or middle-aged people, and they present with a variety of clinical manifestations. Most masses disappear following medical treatment. APS can be accompanied by cardiac myxomas. APS should be promptly investigated in young patients presenting with thrombotic events without any underlying risk factors.<\/jats:p>","DOI":"10.1055\/a-2561-0149","type":"journal-article","created":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T19:05:56Z","timestamp":1744225556000},"page":"768-775","source":"Crossref","is-referenced-by-count":2,"title":["Clinical Features of Antiphospholipid Syndrome with Intracardiac Mass"],"prefix":"10.1055","volume":"51","author":[{"given":"Huiting","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Pathology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Pathology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pathology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of General Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Cardiac Ultrasound, Institute of Angiocardiopathy of Hunan, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7618-1667","authenticated-orcid":false,"given":"Duo","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pathology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,4,9]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"e069717","DOI":"10.1136\/bmj-2021-069717","article-title":"Antiphospholipid syndrome: advances in diagnosis, pathogenesis, and management","volume":"380","author":"J S Knight","year":"2023","journal-title":"BMJ"},{"issue":"09","key":"ref2","first-page":"1000","article-title":"[Recommendations for management of antiphospholipid syndrome in China]","volume":"61","author":"J L Zhao","year":"2022","journal-title":"Zhonghua Nei Ke Za Zhi"},{"issue":"07","key":"ref3","first-page":"951","article-title":"Antiphospholipid antibody syndrome with involvement of a bioprosthetic heart valve","volume":"14","author":"A Niaz","year":"1998","journal-title":"Can J Cardiol"},{"issue":"02","key":"ref4","first-page":"213","article-title":"Intracardiac thrombosis and mitral prosthesis dysfunction in systemic lupus erythematosus. A case report","volume":"22","author":"A N da Silva","year":"2003","journal-title":"Rev Port Cardiol"},{"issue":"02","key":"ref5","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1007\/s12016-007-0013-z","article-title":"The heart and APS","volume":"32","author":"M C Amigo","year":"2007","journal-title":"Clin Rev Allergy Immunol"},{"issue":"05","key":"ref6","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1055\/s-0039-1692702","article-title":"Cardiac manifestations of antiphospholipid syndrome: clinical presentation, role of cardiac imaging, and treatment strategies","volume":"45","author":"A Tufano","year":"2019","journal-title":"Semin Thromb Hemost"},{"issue":"01","key":"ref7","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1186\/s12969-020-00484-z","article-title":"Atrial thrombus as a complication of SLE and APS in an 8-year-old child","volume":"18","author":"H B Yan","year":"2020","journal-title":"Pediatr Rheumatol Online J"},{"issue":"10","key":"ref8","doi-asserted-by":"crossref","first-page":"1687","DOI":"10.1002\/art.42624","article-title":"The 2023 ACR\/EULAR antiphospholipid syndrome classification criteria","volume":"75","author":"M Barbhaiya","year":"2023","journal-title":"Arthritis Rheumatol"},{"issue":"04","key":"ref9","first-page":"e207455","article-title":"Right atrial thrombus mimicking a myxoma: synergism of hormonal contraceptives and antiphospholipid antibodies","volume":"49","author":"Z Hashmath","year":"2022","journal-title":"Tex Heart Inst J"},{"issue":"04","key":"ref10","first-page":"269","article-title":"Left atrial myxoma and antiphospholipid syndrome\u2014a case report","volume":"32","author":"M Meter","year":"2021","journal-title":"Int J Angiol"},{"issue":"01","key":"ref11","doi-asserted-by":"crossref","first-page":"19","DOI":"10.4103\/0970-258X.308236","article-title":"An unusual left ventricular outflow tract mass in a patient with systemic lupus erythematosus","volume":"33","author":"H K Grewal","year":"2020","journal-title":"Natl Med J India"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"253","DOI":"10.2147\/VHRM.S197638","article-title":"Intracardiac thrombus in a patient with catastrophic antiphospholipid syndrome: an autopsy case report and review of the literature","volume":"15","author":"J Waisayarat","year":"2019","journal-title":"Vasc Health Risk Manag"},{"issue":"10","key":"ref13","first-page":"e3438","article-title":"Co-existing bilateral pulmonary embolism and intra-cardiac mass: a case of catastrophic antiphospholipid syndrome-like disease","volume":"10","author":"H Zahid","year":"2018","journal-title":"Cureus"},{"issue":"01","key":"ref14","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1055\/s-0035-1549841","article-title":"Right atrial thrombosis in antiphospholipid syndrome with secondary immune thrombocytopenia","volume":"4","author":"M Voigtlaender","year":"2015","journal-title":"Thorac Cardiovasc Surg Rep"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1016\/j.acvd.2011.05.014","article-title":"Coronary microvasculopathy and intracardiac thrombosis in antiphospholipid syndrome","volume":"105","author":"R Onea","year":"2012","journal-title":"Arch Cardiovasc Dis"},{"issue":"06","key":"ref16","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1093\/ehjci\/jer314","article-title":"Disseminated intracardiac thrombosis: a rare manifestation of antiphospholipid syndrome","volume":"13","author":"N Abanador-Kamper","year":"2012","journal-title":"Eur Heart J Cardiovasc Imaging"},{"issue":"03","key":"ref17","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1055\/s-0030-1250501","article-title":"Inferior vena cava obstruction by a cardiac mass: unusual presentation of primary antiphospholipid syndrome","volume":"59","author":"E Permanyer","year":"2011","journal-title":"Thorac Cardiovasc 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and antiphospholipid syndrome","volume":"10","author":"J A de Agust\u00edn","year":"2009","journal-title":"Eur J Echocardiogr"},{"issue":"04","key":"ref22","first-page":"454","article-title":"Right atrial thrombus mimicking myxoma with pulmonary embolism in a patient with systemic lupus erythematosus and secondary antiphospholipid syndrome","volume":"35","author":"T F Cianciulli","year":"2008","journal-title":"Tex Heart Inst J"},{"issue":"10","key":"ref23","doi-asserted-by":"crossref","first-page":"1290","DOI":"10.1253\/circj.69.1290","article-title":"Antiphospholipid syndrome presenting as intracardiac thrombus with pulmonary embolism","volume":"69","author":"Z X Ye","year":"2005","journal-title":"Circ J"},{"issue":"05","key":"ref24","doi-asserted-by":"crossref","first-page":"1462","DOI":"10.1016\/j.jtcvs.2005.05.054","article-title":"Antiphospholipid syndrome and right atrial mass","volume":"130","author":"C Basso","year":"2005","journal-title":"J Thorac Cardiovasc 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possibly triggered by ovulation induction in a patient with antiphospholipid antibodies","volume":"31","author":"S Andrejevic","year":"2002","journal-title":"Scand J Rheumatol"},{"issue":"03","key":"ref29","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1159\/000057635","article-title":"Intracardiac thrombus in a patient with autoimmune hemolytic anemia leading to a diagnosis of antiphospholipid syndrome","volume":"107","author":"R Latagliata","year":"2002","journal-title":"Acta Haematol"},{"issue":"07","key":"ref30","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1067\/mje.2002.118914","article-title":"Mitral valve thrombus mimicking a primary tumor in the antiphospholipid syndrome","volume":"15","author":"P M Mottram","year":"2002","journal-title":"J Am Soc Echocardiogr"},{"issue":"03","key":"ref31","first-page":"249","article-title":"[A case of mitral regurgitation with a giant thrombus thought to be caused by anti-phospholipid syndrome]","volume":"55","author":"K Tamura","year":"2002","journal-title":"Kyobu Geka"},{"issue":"04","key":"ref32","first-page":"479","article-title":"Antiphospholipid antibodies and intracardiac thrombosis. A case report","volume":"43","author":"G Brancaccio","year":"2002","journal-title":"J Cardiovasc Surg (Torino)"},{"issue":"08","key":"ref33","first-page":"1005","article-title":"[Intracardial thrombosis and primary antiphospholipid syndrome. A familial case report]","volume":"54","author":"N Casanovas","year":"2001","journal-title":"Rev Esp Cardiol"},{"issue":"10","key":"ref34","first-page":"1111","article-title":"[Left atrial thrombosis in patients with antiphospholipid antibody syndrome and mesenchymal abnormal septum]","volume":"2","author":"A Ghirarduzzi","year":"2001","journal-title":"Ital Heart J Suppl"},{"issue":"09","key":"ref35","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1067\/mje.2000.106825","article-title":"Intracardiac thrombus in antiphospholipid antibody syndrome","volume":"13","author":"J A Aguilar","year":"2000","journal-title":"J Am Soc Echocardiogr"},{"issue":"01","key":"ref36","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1159\/000006948","article-title":"Asymptomatic intracardiac thrombi and primary antiphospholipid syndrome","volume":"92","author":"B Granel","year":"1999","journal-title":"Cardiology"},{"issue":"04","key":"ref37","first-page":"380","article-title":"[Primary antiphospholipid antibody syndrome with left atrial intracardiac thombosis]","volume":"27","author":"S Amato","year":"1997","journal-title":"G Ital Cardiol"},{"issue":"06","key":"ref38","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1016\/S0894-7317(96)90486-1","article-title":"Intracardiac thrombi associated with antiphospholipid antibodies","volume":"9","author":"D Plein","year":"1996","journal-title":"J Am Soc Echocardiogr"},{"issue":"03","key":"ref39","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1001\/archinte.1995.00430030123014","article-title":"Dissolution of intracardiac mass lesions in the primary antiphospholipid antibody syndrome","volume":"155","author":"D O'Neill","year":"1995","journal-title":"Arch Intern Med"},{"issue":"02","key":"ref40","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1136\/hrt.74.2.202","article-title":"Left ventricular thrombi in a patient with the antiphospholipid syndrome","volume":"74","author":"D Bruce","year":"1995","journal-title":"Br Heart J"},{"issue":"S 01","key":"ref41","first-page":"S56","article-title":"Recurrent intracardiac mass in a pregnant woman with antiphospholipid syndrome","volume":"7","author":"V Matos","year":"1994","journal-title":"Acta Med Port"},{"issue":"09","key":"ref42","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1097\/00007611-199409000-00014","article-title":"Intracardiac thrombosis and antiphospholipid antibodies: a case report and review of the literature","volume":"87","author":"R A Baum","year":"1994","journal-title":"South Med J"},{"issue":"11","key":"ref43","first-page":"535","article-title":"[Primary antiphospholipid syndrome and cardiac involvement. Description of a clinical case of right atrial thrombosis]","volume":"42","author":"R Villani","year":"1994","journal-title":"Minerva Cardioangiol"},{"issue":"03","key":"ref44","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1136\/hrt.70.3.279","article-title":"Life-threatening right ventricular thrombosis in association with phospholipid antibodies","volume":"70","author":"S O'Hickey","year":"1993","journal-title":"Br Heart J"},{"issue":"08","key":"ref45","first-page":"1293","article-title":"Intracardiac mural thrombus mimicking atrial myxoma in the antiphospholipid syndrome","volume":"19","author":"E Gertner","year":"1992","journal-title":"J Rheumatol"},{"issue":"05","key":"ref46","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.1016\/0002-8703(92)90420-Z","article-title":"Cardiac manifestations of the antiphospholipid syndrome","volume":"124","author":"S D Kaplan","year":"1992","journal-title":"Am Heart J"},{"issue":"07","key":"ref47","first-page":"837","article-title":"[Antiphospholipid syndrome with massive right atrial thrombus. Differential diagnosis of myxoma]","volume":"110","author":"A Kjernsmo","year":"1990","journal-title":"Tidsskr Nor Laegeforen"},{"issue":"06","key":"ref48","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1016\/S0894-7317(05)80021-5","article-title":"Transesophageal echocardiographic diagnosis of right atrial thrombi associated with the antiphospholipid syndrome","volume":"8","author":"S M Day","year":"1995","journal-title":"J Am Soc Echocardiogr"},{"issue":"01","key":"ref49","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/S0002-9343(89)80496-6","article-title":"Antiphospholipid antibody syndrome with right atrial thrombosis mimicking an atrial myxoma","volume":"87","author":"L J Leventhal","year":"1989","journal-title":"Am J Med"},{"issue":"08","key":"ref50","first-page":"1278","article-title":"Severe congestive lupus cardiomyopathy complicated by an intracavitary thrombus: a clinical and echocardiographic followup","volume":"15","author":"H Gur","year":"1988","journal-title":"J Rheumatol"},{"issue":"05","key":"ref51","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1136\/hrt.60.5.455","article-title":"Intracardiac thrombosis, phospholipid antibodies, and two-chambered right ventricle","volume":"60","author":"M A Coppock","year":"1988","journal-title":"Br Heart J"},{"issue":"08","key":"ref52","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1001\/archneur.1985.04210090081022","article-title":"Embolic stroke complicating systemic lupus erythematosus","volume":"42","author":"P B Gorelick","year":"1985","journal-title":"Arch Neurol"},{"key":"ref53","doi-asserted-by":"crossref","first-page":"941","DOI":"10.3389\/fimmu.2019.00941","article-title":"Cardiac manifestations of antiphospholipid syndrome with focus on its primary form","volume":"10","author":"T Kolitz","year":"2019","journal-title":"Front Immunol"},{"issue":"09","key":"ref54","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1002\/art.40901","article-title":"The epidemiology of antiphospholipid syndrome: a population-based study","volume":"71","author":"A Duarte-Garc\u00eda","year":"2019","journal-title":"Arthritis Rheumatol"},{"issue":"05","key":"ref55","doi-asserted-by":"crossref","first-page":"e35","DOI":"10.3346\/jkms.2020.35.e35","article-title":"Epidemiology of antiphospholipid syndrome in Korea: a nationwide population-based study","volume":"35","author":"J J Hwang","year":"2020","journal-title":"J Korean Med Sci"},{"issue":"04","key":"ref56","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1002\/art.10187","article-title":"Antiphospholipid syndrome: clinical and immunologic manifestations and patterns of disease expression in a cohort of 1,000 patients","volume":"46","author":"R Cervera","year":"2002","journal-title":"Arthritis Rheum"},{"issue":"05","key":"ref57","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1016\/j.jtcvs.2007.10.048","article-title":"Analysis of benign ventricular tumors: long-term outcome after resection","volume":"135","author":"A W ElBardissi","year":"2008","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"06","key":"ref58","doi-asserted-by":"crossref","first-page":"1408","DOI":"10.1111\/jth.14798","article-title":"Antiphospholipid syndrome and the relationship between laboratory assay positivity and prevalence of non-bacterial thrombotic endocarditis: a retrospective cohort study","volume":"18","author":"C J Lenz","year":"2020","journal-title":"J Thromb Haemost"}],"container-title":["Seminars in Thrombosis and Hemostasis"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2561-0149.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T23:33:20Z","timestamp":1757720000000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2561-0149"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,9]]},"references-count":58,"journal-issue":{"issue":"07","published-online":{"date-parts":[[2025,9,12]]},"published-print":{"date-parts":[[2025,10]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2561-0149","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0094-6176","1098-9064"],"issn-type":[{"value":"0094-6176","type":"print"},{"value":"1098-9064","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,9]]}}}